Cargando…

Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life

Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length...

Descripción completa

Detalles Bibliográficos
Autores principales: Shah, Vrutangkumar V., McNames, James, Harker, Graham, Mancini, Martina, Carlson-Kuhta, Patricia, Nutt, John G., El-Gohary, Mahmoud, Curtze, Carolin, Horak, Fay B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601493/
https://www.ncbi.nlm.nih.gov/pubmed/33053703
http://dx.doi.org/10.3390/s20205769
_version_ 1783603434657677312
author Shah, Vrutangkumar V.
McNames, James
Harker, Graham
Mancini, Martina
Carlson-Kuhta, Patricia
Nutt, John G.
El-Gohary, Mahmoud
Curtze, Carolin
Horak, Fay B.
author_facet Shah, Vrutangkumar V.
McNames, James
Harker, Graham
Mancini, Martina
Carlson-Kuhta, Patricia
Nutt, John G.
El-Gohary, Mahmoud
Curtze, Carolin
Horak, Fay B.
author_sort Shah, Vrutangkumar V.
collection PubMed
description Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson’s disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD.
format Online
Article
Text
id pubmed-7601493
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76014932020-11-01 Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life Shah, Vrutangkumar V. McNames, James Harker, Graham Mancini, Martina Carlson-Kuhta, Patricia Nutt, John G. El-Gohary, Mahmoud Curtze, Carolin Horak, Fay B. Sensors (Basel) Article Although the use of wearable technology to characterize gait disorders in daily life is increasing, there is no consensus on which specific gait bout length should be used to characterize gait. Clinical trialists using daily life gait quality as study outcomes need to understand how gait bout length affects the sensitivity and specificity of measures to discriminate pathological gait as well as the reliability of gait measures across gait bout lengths. We investigated whether Parkinson’s disease (PD) affects how gait characteristics change as bout length changes, and how gait bout length affects the reliability and discriminative ability of gait measures to identify gait impairments in people with PD compared to neurotypical Old Adults (OA). We recruited 29 people with PD and 20 neurotypical OA of similar age for this study. Subjects wore 3 inertial sensors, one on each foot and one over the lumbar spine all day, for 7 days. To investigate which gait bout lengths should be included to extract gait measures, we determined the range of gait bout lengths available across all subjects. To investigate if the effect of bout length on each gait measure is similar or not between subjects with PD and OA, we used a growth curve analysis. For reliability and discriminative ability of each gait measure as a function of gait bout length, we used the intraclass correlation coefficient (ICC) and area under the curve (AUC), respectively. Ninety percent of subjects walked with a bout length of less than 53 strides during the week, and the majority (>50%) of gait bouts consisted of less than 12 strides. Although bout length affected all gait measures, the effects depended on the specific measure and sometimes differed for PD versus OA. Specifically, people with PD did not increase/decrease cadence and swing duration with bout length in the same way as OA. ICC and AUC characteristics tended to be larger for shorter than longer gait bouts. Our findings suggest that PD interferes with the scaling of cadence and swing duration with gait bout length. Whereas control subjects gradually increased cadence and decreased swing duration as bout length increased, participants with PD started with higher than normal cadence and shorter than normal stride duration for the smallest bouts, and cadence and stride duration changed little as bout length increased, so differences between PD and OA disappeared for the longer bout lengths. Gait measures extracted from shorter bouts are more common, more reliable, and more discriminative, suggesting that shorter gait bouts should be used to extract potential digital biomarkers for people with PD. MDPI 2020-10-12 /pmc/articles/PMC7601493/ /pubmed/33053703 http://dx.doi.org/10.3390/s20205769 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shah, Vrutangkumar V.
McNames, James
Harker, Graham
Mancini, Martina
Carlson-Kuhta, Patricia
Nutt, John G.
El-Gohary, Mahmoud
Curtze, Carolin
Horak, Fay B.
Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title_full Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title_fullStr Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title_full_unstemmed Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title_short Effect of Bout Length on Gait Measures in People with and without Parkinson’s Disease during Daily Life
title_sort effect of bout length on gait measures in people with and without parkinson’s disease during daily life
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601493/
https://www.ncbi.nlm.nih.gov/pubmed/33053703
http://dx.doi.org/10.3390/s20205769
work_keys_str_mv AT shahvrutangkumarv effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT mcnamesjames effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT harkergraham effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT mancinimartina effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT carlsonkuhtapatricia effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT nuttjohng effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT elgoharymahmoud effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT curtzecarolin effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife
AT horakfayb effectofboutlengthongaitmeasuresinpeoplewithandwithoutparkinsonsdiseaseduringdailylife